Effect of treatment of isolated systolic hypertension on left ventricular mass.

Autor: Ofili, Elizabeth O., Cohen, Jerome D., St. Vrain, Jeanette A., Pearson, Anthony, Martin, Timothy J., Uy, Norbert D., Castello, Ramon, Labovitz, Arthur J., Ofili, E O, Cohen, J D, St Vrain, J A, Pearson, A, Martin, T J, Uy, N D, Castello, R, Labovitz, A J
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Zdroj: JAMA: Journal of the American Medical Association; 3/11/98, Vol. 279 Issue 10, p778-780, 3p, 1 Chart, 2 Graphs
Abstrakt: Context: Left ventricular (LV) hypertrophy is a common problem among elderly patients with isolated systolic hypertension (ISH), but the effect of treatment of ISH on LV mass is not known.Objective: To assess the ability of antihypertensive drug treatment to reduce LV mass in ISH.Design: Echocardiographic Substudy of the Systolic Hypertension in the Elderly Program (SHEP).Patients: A total of 104 participants at the St Louis SHEP site who had interpretable baseline echocardiograms, 94 of whom had 3-year follow-up echocardiograms.Intervention: The SHEP participants were randomized to placebo or active treatment with chlorthalidone (12.5-25 mg/d), with atenolol (25-50 mg/d) added if necessary to maintain goal blood pressure.Main Outcome Measure: Change in LV mass assessed by echocardiography.Results: Minimum follow-up was 3 years. In the active treatment group, 91% and 80% of subjects were receiving treatment with chlorthalidone alone by the end of years 1 and 3, respectively. The LV mass index was 93 g/m2 in the active treatment group and 100 g/m2 in the placebo group (P<.001). The LV mass index declined by 13% (95% confidence interval, - 3% to - 23%) in the active treatment group compared with a 6% increase (95% confidence interval, - 3% to + 16%) in the placebo group over 3 years (P=.01).Conclusion: Treatment of ISH with a diuretic-based regimen reduces LV mass. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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